


From the Files of Nicholas J. Fury, MD

by pipisafoat



Series: Stark Hospital for Independent Emotional Life Determination [1]
Category: Marvel Cinematic Universe, The Avengers (Marvel Movies), The Avengers (Marvel) - All Media Types, The Incredible Hulk (2008)
Genre: Alternate Universe - Hospital, Alternate Universe - No Powers, Alternate Universe - Psychiatric Hospital, Delusions, Depression, Dissociative Identity Disorder, Flashbacks, Gen, Homicidal Thoughts, Homicidal Threats, Hospitalization, Implied/Referenced Suicide, Involuntary Hospitalization, Nightmares, PTSD, Paranoia, Paranoid Delusions, Post-Traumatic Stress Disorder, Post-Traumatic Stress Disorder - PTSD, Psychologists & Psychiatrists, Self-Harm, Suicidal Thoughts, Suicide Attempt, Voluntary Hospitalization, major depression disorder
Language: English
Status: In-Progress
Published: 2016-09-20
Updated: 2016-12-30
Packaged: 2018-08-16 10:02:14
Rating: Teen And Up Audiences
Warnings: Creator Chose Not To Use Archive Warnings
Chapters: 3
Words: 1,054
Publisher: archiveofourown.org
Story URL: https://archiveofourown.org/works/8097883
Author URL: https://archiveofourown.org/users/pipisafoat/pseuds/pipisafoat
Summary: Dr. Fury has his hands full with the patients on the A Wing of the Stark Hospital for Independent Emotional Life Determination (or the Mental SHIELD, as he sometimes calls it). These are some of his clinical documents on the patients who will get bored and decide that the A in A Wing needs to stand for Avengers.Notes at the end of each chapter will contain spoilers in the form of content warnings. However, none of these are particularly graphic; Dr. Fury writes professional notes with the occasional sentence-long quote from his patients.Also, I am not affiliated with any drug company whose products are included in this fic.





	1. 9/15 - R. Bruce Banner - Admission Note

Robert Bruce Banner is a 47 year old white male presenting to the clinic of Stark Hospital for Independent Emotional Life Determination voluntarily due to recent unsuccessful suicide attempt. Dr. Banner holds a PhD in physics with extensive publications and honors in his field but has not worked as a physicist in any manner for the past two years following a laboratory accident involving gamma radiation. Dr. Banner is currently unemployed and is receiving social security disability benefits for side effects from the laboratory accident. He lives alone and reports rarely leaving his home.

Dr. Banner presents with two previously diagnosed psychiatric conditions: dissociative identity disorder and major depression. Each of these diagnoses were made at separate times but both postdate the laboratory accident and are believe to be caused in part but not in whole by the exposure to gamma radiation. Dr. Banner’s depressive symptoms are typical of the disorder and include a history of self harming and suicidal thoughts; this is his first known suicide attempt. Dr. Banner is one of three distinct persons co-existing in his mind and is the one most frequently interacting with the outside world. The second most frequently seen is an alter named Robby, a young Bruce Banner who remains at a constant age of five years old. Robby has memories of Dr. Banner’s childhood to the age of five and of the past two years since his creation as an alter. The final alter is a non-human named Hulk who infrequently interacts with the world. Hulk is conceived of as a large green being of immense strength whose major personality characteristic is anger. Hulk is largely preverbal, using only three words at present: Hulk, smash, and no. Hulk’s intelligence, understanding of the world around him, awareness of Dr. Banner and Robby, and memories of times when the other two are out in the world all remain unknown due to Hulk’s low verbal abilities and infrequent interactions. Dr. Banner is aware of the other two only second-hand and retains no memory of events when either is interacting with the world. He refers to them almost exclusively as “the kid” and “the other guy.” Robby is directly aware of both Dr. Banner (whom he considers to be his father) and Hulk (of whom he is afraid) and appears to retain all memories viewed through his childish lens.

During his admission interview today, Dr. Banner indicated that his suicide attempt was thwarted by Hulk: “I put a bullet in my mouth, and the other guy spit it out.” He also stated that he felt as though his depression had been steadily worsening despite his outpatient efforts to counteract the disorder. Dr. Banner indicated for the first time some paranoid delusions preventing him from feeling comfortable and confident leaving his home. He is afraid of the pursuit of unknown entities seeking to lay hands on Hulk and on his research into gamma radiation; these entities include unspecified branches of the United States military.

Dr. Banner was admitted this afternoon into the inpatient wing at SHIELD under a planned stay of 5-7 days as needed to stabilize his medications and ensure his continued safety. As of the evening medication pass, Dr. Banner will begin to taper off of his Lexapro and begin taking Remeron.

_Attached orders:_

_Robert Bruce Banner_  
_MR# 0054685  
DOB 12/18/1969_

_09/15/2016 15:25_

_Admit to A wing for inpatient dx & tx_

_Signature:_  
_Nicholas J Fury, MD  
NY State License #55843_

_Robert Bruce Banner_  
_MR# 0054685  
DOB 12/18/1969_

_09/15/2016 15:27_

_Reduce escitalopram oxalate to 15 mg po qhs  
Start mirtazapine 15 mg po qhs_

_Signature:_  
_Nicholas J Fury, MD  
NY State License #55843_

**Notes for the Chapter:**

> Content notes: clinical descriptions of depression, suicidal thoughts/actions, dissociative identity disorder


	2. 9/17 - Natalia Romanoff - Transfer Note

Natasha continues to be compliant with her plan of care and participates in at least 50% of skills training sessions she is able to attend. Her last homicidal threat was four days prior, though she reports continued homicidal thoughts/urges and paranoia. Following the recent reassignment of floor staff to minimize her contact with female staff members, Natasha has shown a marked reduction in number and severity of flashbacks and nightmares related to her PTSD. She still refuses to elaborate at all on her history of trauma with myself or with Sam Wilson, LPC. She has, however, begun to open up about recent events leading to her involuntary admission to the intensive inpatient wing six days ago and is applying her newly learned emotional regulation skills more frequently and with greater success.

With this progress in mind, I have written an order for her transfer this afternoon to the regular inpatient wing to continue with skills training sessions and begin attending group therapy sessions as well. Sam Wilson, LPC, recommends continued involuntary commitment for a time of at least one week before Natasha’s discharge to intensive outpatient care; my review of his therapy notes as well as an interview with Natasha leads me to agree with his recommendation pending continued observation of patient. I will see her daily during her stay in the inpatient wing to assess her progress and further medication needs, though she appears to be tolerating this most recent dosage adjustment without issue.

_Attached orders:_

_Natalia Alianovna Romanoff_  
_MR# 0054682_  
_DOB 11/22/1984_

_09/17/2016 09:45_

_Transfer to A Wing to continue tx per POC_

_Signature:_  
_Nicholas J Fury, MD_  
_NY State License #55843_


	3. 9/17 - R. Bruce Banner - Progress Note

Dr. Banner reports again today severe AM fatigue with no other side effects; due to the nature of the progression of side effects, I will increase his dosage as of this evening. He continues to report no change in depressive symptoms. However, James Rhodes has noted a slight decrease in Dr. Banner’s paranoid delusions or at least a decrease in his verbalization of those delusions. James will continue to keep track of this symptom during his daily individual therapy sessions with Dr. Banner. It is my hope that this is only the first of many symptoms that will be reduced by the Remeron. Additionally, he is tolerating well the decrease in Lexapro and will titrate further today.

_Attached orders:_

_Robert Bruce Banner  
MR# 0054685  
DOB 12/18/1969_

_09/17/2016 11:57_

_Reduce escitalopram oxalate to 10 mg po qhs  
Increase mirtazapine to 30 mg po qhs_

_Signature:  
Nicholas J. Fury, MD  
NY State License #55843_


End file.
